scholarly journals Individual response to antidepressants for depression in adults – a meta-analysis and simulation study

2019 ◽  
Author(s):  
Klaus Munkholm ◽  
Stephanie Winkelbeiner ◽  
Philipp Homan
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Meta Analysis ◽  
Simulated Data ◽  
Individual Treatment ◽  
Depression Symptom ◽  
Individual Response ◽  
Inverse Variance ◽  
The Individual ◽  
Symptom Rating

Background The observation that some patients appear to respond better to antidepressants for depression than others encourages the assumption that the effect of antidepressants differs between individuals and that treatment can be personalized. Objective To compare the outcome variance in patients receiving antidepressants with the outcome variance in patients receiving placebo in randomized controlled trials (RCTs) of adults with major depressive disorder (MDD) and to illustrate, using simulated data, components of variation of RCTs. Methods From a dataset comprising 522 RCTs of antidepressants for adult MDD, we selected the placebo-controlled RCTs reporting outcomes on the 17 or 21 item Hamilton Depression Rating Scale or the Montgomery-Asberg Depression Rating Scale and extracted the means and SDs of raw endpoint scores or baseline to endpoint changes scores on eligible depression symptom rating scales. We conducted inverse variance random-effects meta-analysis with the variability ratio (VR), the ratio between the outcome variance in the group of patients receiving antidepressants and the outcome variance in the group receiving placebo, as the primary outcome. An increased variance in the antidepressant group would indicate individual differences in response to antidepressants. Results We analysed 222 RCTs that investigated 19 different antidepressants compared with placebo in 345 comparisons, comprising a total of 61144 adults with an MDD diagnosis. Across all comparisons, the VR for raw endpoint scores was 0.98 (95% CI 0.96 to 1.00, I^2^ = 0%) and 1.00 (95% CI 0.99 to 1.02, I^2^ = 0%) for baseline-to-endpoint change scores. Conclusion Based on these data, we cannot reject the null hypothesis of equal variances in the antidepressant group and the placebo group. Given that RCTs cannot provide direct evidence for individual treatment effects, it may be most reasonable to assume that the average effect of antidepressants applies also to the individual patient.

scholarly journals Individual response to antidepressants for depression in adults – a simulation study and meta-analysis

2019 ◽  
Author(s):  
Klaus Munkholm ◽  
Stephanie Winkelbeiner ◽  
Philipp Homan
Keyword(s):  
Individual Differences ◽  
Simulation Study ◽  
Variance Components ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Meta Analysis ◽  
Empirical Support ◽  
Individual Response ◽  
Inverse Variance ◽  
Meta Analyses

Background. The observation that some patients appear to respond better to antidepressants for depression than others encourages the assumption that the effect of antidepressants differs between individuals and that treatment can be personalized. To test this assumption, we compared the outcome variance in the group of patients receiving antidepressants with the outcome variance of the group of patients receiving placebo in randomized controlled trials (RCTs) of adults with major depressive disorder (MDD). An increased variance in the antidepressant group would indicate individual differences in response to antidepressants. In addition, we illustrate in a simulation study why attempts to personalize antidepressant treatment using RCTs might be misguided.Methods. We first illustrated the variance components of trials by simulating RCTs and crossover trials of antidepressants versus placebo. Second, we analyzed data of a large meta-analysis of antidepressants for depression, including a total of 222 placebo-controlled studies from the dataset that reported outcomes on the 17 or 21 item Hamilton Depression Rating Scale or the Montgomery-Åsberg Depression Rating Scale. We performed inverse variance, random-effects meta-analyses of the variability ratio (VR) between the antidepressant and placebo groups. Outcomes. The meta-analyses of the VR comprised 345 comparisons of 19 different antidepressants with placebo in a total of 61144 adults with an MDD diagnosis. Across all comparisons, we found no evidence for a larger variance in the antidepressant group compared with placebo overall (VR = 1.00, 95% CI: 0.98; 1.01, I2 = 0%) or for any individual antidepressant. Interpretation. Our findings did not provide empirical support for individual differences in response to antidepressants.

scholarly journals Development of the Mental, Emotional, and Bodily Toughness Inventory in Collegiate Athletes and Nonathletes

2008 ◽  
Vol 43 (2) ◽  
pp. 125-132 ◽  
Author(s):  
Mick G. Mack ◽  
Brian G. Ragan
Keyword(s):  
Undergraduate Students ◽  
Rating Scale ◽  
Collegiate Athletes ◽  
Rehabilitation Program ◽  
Mental Toughness ◽  
Individual Treatment ◽  
Model Data ◽  
Fit Statistics ◽  
The People ◽  
The Individual

Abstract Context: The assessment of an individual's mental toughness would assist clinicians in enhancing an individual's performance, improving compliance with the rehabilitation program, and improving the individual treatment program. However, no sound measure of mental toughness exists. Objective: To develop a new measure of mental toughness, the Mental, Emotional, and Bodily Toughness Inventory (MeBTough). Design: Participants were invited to complete a 45-item questionnaire. Setting: University research laboratory. Patients or Other Participants: A total of 261 undergraduate students were recruited to complete the questionnaire. Main Outcome Measure(s): The Rasch-calibrated item difficulties, fit statistics, and persons' mental toughness ability estimates were examined for model-data fit of the MeBTough. Results: Forty-three of the 45 items had good model-data fit with acceptable fit statistics. Results indicated that the distribution of items was fittingly targeted to the people and the collapsed rating scale functioned well. The item separation index (6.31) and separation reliability statistic (.98) provided evidence that the items had good variability with a high degree of confidence in replicating placement of the items from another sample. Conclusions: Results provided support for using the new measure of mental, emotional, and bodily toughness.

Clinical target syndromes in psychiatry: latent structure analysis versus factor analysis

1991 ◽  
Vol 6 (6) ◽  
pp. 301-306 ◽  
Author(s):  
P Bech
Keyword(s):  
Factor Analysis ◽  
Structure Analysis ◽  
Statistical Models ◽  
Rating Scales ◽  
Rating Scale ◽  
Latent Structure ◽  
Depression And Anxiety ◽  
Sufficient Statistics ◽  
Latent Structure Analysis ◽  
Symptom Rating

SummaryThe algorithms for the demonstration of shared phenomenology of psychiatric syndromes in DSM-III are resistant to quantification. In contrast, the rating scale approach quantifies clinical target syndromes in psychiatry. The two most useful statistical models for quantifying shared phenomenology by symptom rating scales have been reviewed; namely factor analysis and latent structure analysis. Results have shown that factor analysis has demonstrated dimensions of dementia, delirium, schizophrenia, mania, outward aggression, depression and anxiety. Latent structure analysis has confirmed that the items of brief rating scales (such as the Melancholia Scale) are additively related implying that their total scores are sufficient statistics for the measurement of these factors or dimensions. Latent structure analysis should be considered as a psychometric “glasnost” compared to algorithm-resistant logic of quantification in DSM-III.

scholarly journals The Validity of Teacher Rating Scales for the Assessment of ADHD Symptoms in the Classroom: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 108705472091683
Author(s):  
Anouck I. Staff ◽  
Jaap Oosterlaan ◽  
Saskia van der Oord ◽  
Pieter J. Hoekstra ◽  
Karen Vertessen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Convergent Validity ◽  
Rating Scales ◽  
Rating Scale ◽  
Meta Analysis ◽  
Teacher Rating ◽  
Impulsive Behavior ◽  
Adhd Symptoms ◽  
Clinical Interviews ◽  
Scale Scores

Objective: To assess attention-deficit/hyperactivity disorder (ADHD) symptoms in the classroom, most often teacher rating scales are used. However, clinical interviews and observations are recommended as gold standard assessment. This systematic review and meta-analysis evaluates the validity of teacher rating scales. Method: Twenty-two studies ( N = 3,947 children) assessing ADHD symptoms using teacher rating scale and either semi-structured clinical interview or structured classroom observation were meta-analyzed. Results: Results showed convergent validity for rating scale scores, with the strongest correlations ( r = .55–.64) for validation against interviews, and for hyperactive–impulsive behavior. Divergent validity was confirmed for teacher ratings validated against interviews, whereas validated against observations this was confirmed for inattention only. Conclusion: Teacher rating scales appear a valid and time-efficient measure to assess classroom ADHD; although validated against semi-structured clinical interviews, there were only a few studies available. Low correlations between ratings and structured observations of inattention suggest that observations could add information above rating scales.

scholarly journals Incidence and Impact of Acute Kidney Injury after Liver Transplantation: A Meta-Analysis

2019 ◽  
Vol 8 (3) ◽  
pp. 372 ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Kaewput ◽  
Natanong Thamcharoen ◽  
Tarun Bathini ◽  
Kanramon Watthanasuntorn ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Graft Failure ◽  
Meta Analysis ◽  
Random Effect ◽  
Kidney Injury ◽  
Incidence Rates ◽  
Liver Graft ◽  
Inverse Variance ◽  
Increased Risk ◽  
The Individual

Background: The study’s aim was to summarize the incidence and impacts of post-liver transplant (LTx) acute kidney injury (AKI) on outcomes after LTx. Methods: A literature search was performed using the MEDLINE, EMBASE and Cochrane Databases from inception until December 2018 to identify studies assessing the incidence of AKI (using a standard AKI definition) in adult patients undergoing LTx. Effect estimates from the individual studies were derived and consolidated utilizing random-effect, the generic inverse variance approach of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42018100664). Results: Thirty-eight cohort studies, with a total of 13,422 LTx patients, were enrolled. Overall, the pooled estimated incidence rates of post-LTx AKI and severe AKI requiring renal replacement therapy (RRT) were 40.7% (95% CI: 35.4%–46.2%) and 7.7% (95% CI: 5.1%–11.4%), respectively. Meta-regression showed that the year of study did not significantly affect the incidence of post-LTx AKI (p = 0.81). The pooled estimated in-hospital or 30-day mortality, and 1-year mortality rates of patients with post-LTx AKI were 16.5% (95% CI: 10.8%–24.3%) and 31.1% (95% CI: 22.4%–41.5%), respectively. Post-LTx AKI and severe AKI requiring RRT were associated with significantly higher mortality with pooled ORs of 2.96 (95% CI: 2.32–3.77) and 8.15 (95%CI: 4.52–14.69), respectively. Compared to those without post-LTx AKI, recipients with post-LTx AKI had significantly increased risk of liver graft failure and chronic kidney disease with pooled ORs of 3.76 (95% CI: 1.56–9.03) and 2.35 (95% CI: 1.53–3.61), respectively. Conclusion: The overall estimated incidence rates of post-LTx AKI and severe AKI requiring RRT are 40.8% and 7.0%, respectively. There are significant associations of post-LTx AKI with increased mortality and graft failure after transplantation. Furthermore, the incidence of post-LTx AKI has remained stable over the ten years of the study.

scholarly journals Visual assessment of movement quality in the single leg squat test: a review and meta-analysis of inter-rater and intrarater reliability

2019 ◽  
Vol 5 (1) ◽  
pp. e000541 ◽  
Author(s):  
John Ressman ◽  
Wilhelmus Johannes Andreas Grooten ◽  
Eva Rasmussen Barr
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Meta Analysis ◽  
Intraclass Correlation ◽  
Cochrane Library ◽  
Intrarater Reliability ◽  
Rater Reliability ◽  
Movement Quality ◽  
Step Down ◽  
Single Leg Squat

Single leg squat (SLS) is a common tool used in clinical examination to set and evaluate rehabilitation goals, but also to assess lower extremity function in active people.ObjectivesTo conduct a review and meta-analysis on the inter-rater and intrarater reliability of the SLS, including the lateral step-down (LSD) and forward step-down (FSD) tests.DesignReview with meta-analysis.Data sourcesCINAHL, Cochrane Library, Embase, Medline (OVID) and Web of Science was searched up until December 2018.Eligibility criteriaStudies were eligible for inclusion if they were methodological studies which assessed the inter-rater and/or intrarater reliability of the SLS, FSD and LSD through observation of movement quality.ResultsThirty-one studies were included. The reliability varied largely between studies (inter-rater: kappa/intraclass correlation coefficients (ICC) = 0.00–0.95; intrarater: kappa/ICC = 0.13–1.00), but most of the studies reached ‘moderate’ measures of agreement. The pooled results of ICC/kappa showed a ‘moderate’ agreement for inter-rater reliability, 0.58 (95% CI 0.50 to 0.65), and a ‘substantial’ agreement for intrarater reliability, 0.68 (95% CI 0.60 to 0.74). Subgroup analyses showed a higher pooled agreement for inter-rater reliability of ≤3-point rating scales while no difference was found for different numbers of segmental assessments.ConclusionOur findings indicate that the SLS test including the FSD and LSD tests can be suitable for clinical use regardless of number of observed segments and particularly with a ≤3-point rating scale. Since most of the included studies were affected with some form of methodological bias, our findings must be interpreted with caution.PROSPERO registration numberCRD42018077822.

Nominations, Ratings, and the Dimensions of Sociometric Status

1997 ◽  
Vol 21 (1) ◽  
pp. 179-199 ◽  
Author(s):  
Gerard H. Maassen ◽  
Jos L. van der Linden ◽  
Wies Akkermans
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Sociometric Status ◽  
Dimensional Model ◽  
One Dimensional ◽  
Individual Level ◽  
Research Designs ◽  
The One ◽  
The Individual ◽  
Group Member

In 1944, U. Bronfenbrenner remarked on the need for a two-dimensional model of sociometric status. The low value of the correlation between the variables liking and disliking-assumed basic dimensions of sociometric status-is often cited as evidence for the correctness of Bronfenbrenner’ssuggestion. Sociometric status is derived from a coalescence of judgements at the individual level. In this article we argue that score attribution at this level (where one group member assesses another) is one-dimensional along the liking-disliking continuum. Two-dimensionality of sociometric status arises at the group level. However, we also show that at this level liking and disliking are not two distinct dimensions, but the poles of just one, the other being visibility (or impact). If the one-dimensional model of liking score attribution on the individual level is accepted, the obvious thing to do is to instruct respondents accordingly. Rating scales are suitable for this. The rating-scale methods we suggested in previous publications (e.g. Maassen, Akkermans, & van der Linden, 1996) are in keeping with this argument. Moreover, these methods may be recommended for their reliability, validity and for the variety of research designs to which they can be applied.

scholarly journals Functional Rating Scales in Spinal and Bulbar Muscular Atrophy: A Systematic Review, Meta-Analysis and Critical Appraisal of their Measurement Properties

2021 ◽  
Author(s):  
Agessandro Abrahao ◽  
LIANE PHUNG ◽  
Eliza Freitas ◽  
Cornelia M Borkhoff ◽  
Lorne Zinman
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Rating Scales ◽  
Rating Scale ◽  
Muscular Atrophy ◽  
Meta Analysis ◽  
Motor Dysfunction ◽  
Measurement Properties ◽  
Patient Reported ◽  
Spinal Bulbar Muscular Atrophy

Tracking disease progression and treatment effect of spinal bulbar muscular atrophy, or Kennedy's disease, is challenging given its slowly progressive nature. To achieve success in SBMA clinical trials, a reliable, responsive, and validated patient-reported motor function scale must capture progression of SBMA-specific motor dysfunction. Here, we conducted a systematic review, meta-analysis, and appraisal of core measurement properties of the SBMA functional rating scale (SBMAFRS). We established that the SBMAFRS has satisfactory internal consistency, inter-rater reliability, and construct validity for measuring progressive motor dysfunction over similar neurodegenerative motor function scales but inadequate sensitivity to change over time. Further development to validate and improve the SBMAFRS' ability to capture longitudinal responsiveness in larger cohorts is warranted.

scholarly journals Histamine Antagonists to Temper the Cytokine Overproduction in Gastrointestinal Cells Infected by SARS-CoV-2

2020 ◽  
Author(s):  
Han Geurdes ◽  
Ivo Koutsaroff
Keyword(s):  
Meta Analysis ◽  
Individual Response ◽  
Natural Immunity ◽  
Cytokine Storm ◽  
Histamine Antagonists ◽  
Virus Particles ◽  
Gastrointestinal Problems ◽  
On Line ◽  
H4 Receptor ◽  
The Individual

The premise regarding COVID-19 disease is that it is a spectrum which begins with infection with viral SARS-CoV-2 exposure via airborne or oral virus particles. The individual response to it depends on many factors including co-morbid conditions. An important aspect of SARS-CoV-2 virus infection is the cytokine storm that develops after the infection. The immuno-chemical chaos created in this cytokine storm is to the benefit of the virus. In this meta analysis the authors explore ways to let the cytokine storm die down by looking into the role of histamine. Histamine is a metabolic product of the essential aminoacid histidine. Histamine has 4 known receptors: H1, H2, H3 and H4. The immunoglobulines IgE and IgM are indicative for a COVID-19 infection. This immune response is related to inflammation. Inflammation, in turn, runs mainly via histamine after e.g. virus inoculation. The goal of the meta-study is to gather evidence to primarily block the H4 receptor (H4R) in gastrointestinal cells to diminish the cytokine overproduction in the $\approx$ 30\% of the patients suffering from gastrointestinal problems caused by SARS-CoV-2. Our concept is as follows. If we can strike a careful balance between hampering the gastrointestinal spreading of the virus and histamine antagonists to tackle the cytokine storm, then the natural immunity can later on come on line again and attack the virus without being led astray by cytokine chaos. We will concentrate on H4R but also look at H1R and H2R related effects. The proposed substances in our systemic approach can be balanced for an effective early treatment. The nature of our work is by its method and results theoretical. In that respect we also may note the structural chemistry indol skeleton resemblance among a number of different drugs.

scholarly journals Symptom rating scales for schizophrenia and other primary psychotic disorders in ICD-11

2017 ◽  
Vol 27 (3) ◽  
pp. 219-224 ◽  
Author(s):  
J. W. Keeley ◽  
W. Gaebel
Keyword(s):  
Negative Symptoms ◽  
Rating Scales ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Field Testing ◽  
International Classification Of Diseases ◽  
Severity Rating ◽  
Classification Of Diseases ◽  
The Cost ◽  
Symptom Rating

The subtype system for categorising presentations of schizophrenia will be removed from International Classification of Diseases 11th Revision. In its place will be a system for rating six domains of psychotic disorder pathology: positive symptoms, negative symptoms, depressive symptoms, manic symptoms, psychomotor symptoms and cognitive symptoms. This paper outlines the rationale and description of the proposed symptom rating scale, including current controversies. In particular, the scale could adopt either a 4-point severity rating or a 2-point presence/absence rating. The 4-point scale has the advantage of gathering more information, but potentially at the cost of reliability. The paper concludes by describing the field testing process for evaluating the proposed scale.

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